文章基本信息

标题：Rural Health Disparities, Population Health, and Rural Culture
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作者：David Hartley
期刊名称：American journal of public health
印刷版ISSN：0090-0036
出版年度：2004
卷号：94
期号：10
页码：1675-1678
语种：English
出版社：American Public Health Association
摘要：In this commentary, I place the maturing field of rural health research and policy in the context of the rural health disparities documented in Health United States, 2001, Urban and Rural Health Chartbook. Because of recent advances in our understanding of the determinants of health, the field must branch out from its traditional focus on access to health care services toward initiatives that are based on models of population health. In addition to presenting distinct regional differences, the chartbook shows a pattern of risky health behaviors among rural populations that suggest a “rural culture” health determinant. This pattern suggests that there may be environmental and cultural factors unique to towns, regions, or United States Department of Agriculture (USDA) economic types that affect health behavior and health. IN THIS COMMENTARY, I consider the historical focus of rural health research and policy on access to hospitals, primary care, and other health services, and I call for a shift toward a population health approach to rural health. Over the past decade, empirical studies have presented evidence that medical care contributes relatively little to health when compared with social and societal factors, environmental factors, health behaviors, and genetics. The Health United States 2001, Urban and Rural Health Chartbook 1 presents a pattern of risky health behaviors among rural populations that suggests a “rural culture” health determinant. It also presents distinct regional differences. Responding to regionally diverse behavioral risk factors is a challenge for the maturing field of rural health.